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Goals of Drug-resistant Tuberculosis (DR-TB) treatment under the National Tuberculosis Elimination Program (NTEP) are as follows:

There are different scenarios regarding patient-wise box (PWB) management. These are described below.

Scenario 1: Modification in regimen

In this scenario, the nodal and district drug-resistant tuberculosis centre (N/DDR-TBC) committee decides on a regimen modification.

Feedback after RBRC

The DR-TB drugs are the Second Line Drugs (SLD) prescribed to the TB patients based on resistance pattern. The treatment duration varies from 9-20 months depending on the regimen being administered. These drugs are supplied as monthly Patient Wise Boxes (PWB) of Type A and Type B .The Type A boxes contains drugs that are common in Intensive Phase (IP) and Continuation Phase (CP) and Type B box contains drugs that are given only during the IP. 

The Flow of DR-TB Drugs in NTEP

In supply chain management under the National TB Elimination Programme (NTEP), the term receipt refers to the act of receiving anti-tuberculosis drugs and other commodities by the State Drug Stores (SDSs) in response to the requests made by the states.

Complete information on all the TB cases with regard to diagnosis and case management is essential to reduce TB transmission and address the problem of the emergence of Drug-resistance TB (DR-TB).

To keep a track of all the TB patients across the country, the government of India introduced a system called Ni-kshay. The word is a combination of two Hindi words "Ni" and "kshay" meaning eradication of tuberculosis.

Cartridge-based Nucleic Acid Amplification Test (CBNAAT) is used to detect Mycobacteria tuberculosis and rifampicin-resistance using GeneXpert IV Dx system and the Xpert MTB/ RIF cartridge.

The CBNAAT system integrates and automates sample processing, nucleic acid amplification, and detection of Mycobacteria tuberculosis and rifampicin resistance.

The system utilises the use of single-use disposable CBNAAT cartridges that hold the Polymerase Chain Reaction (PCR) reagents and hosts the PCR process.

The process involves the following steps:

Expiry management of supplies is crucial to avoid financial losses and harm to patients.

Physical Verification of stock is a two-step process:

1. Physical Verification of Supplies
2. Recording the Change in Ni-kshay Aushadhi